Validation of methods for effective orifice area measurement of prosthetic valves by two-dimensional and Doppler echocardiography following transcatheter self-expanding aortic valve implantation

作     者：Ming-Hu XIAO Yong-Jian WU Jing-Jin WANG Guang-Yuan SONG Jian-De WANG Zhen-Hui ZHU Xu WANG Zhen-Yan ZHAO Hao WANG Ming-Hu XIAO;Yong-Jian WU;Jing-Jin WANG;Guang-Yuan SONG;Jian-De WANG;Zhen-Hui ZHU;Xu WANG;Zhen-Yan ZHAO;Hao WANG

作者机构：Department of EchocardiographyFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of CardiologyFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of SurgeryFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina 

出 版 物：《Journal of Geriatric Cardiology》 (老年心脏病学杂志（英文版）)

年 卷 期：2020年第17卷第12期

页      面：766-774页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Aortic valve stenosis Echocardiography Transcatheter aortic valve implantation 

摘      要：Background The effective orifice area(EOA)is utilized to characterize the hemodynamic performance of the transcatheter heart valve(THV).However,there is no consensus on EOA measurement of self-expanding *** aimed to compare two echocardiographic methods for EOA measurement following transcatheter self-expanding aortic valve *** EOA was calculated according to the continuity *** methods were *** Method 1 and Method 2,the left ventricular outflow tract diameter(LVOTd)was measured at the entry of the prosthesis(from trailing-to-leading edge)and proximal to the prosthetic valve leaflets(from trailing-toleading edge),*** velocity-time integral(VTI)of the LVOT(VTILVOT)was recorded by pulsed-wave Doppler(PW)from apical *** region of the PW sampling should match that of the LVOTd measurement with precise *** mean transvalvular pressure gradient(MG)and VTI of THV was measured by Continuous wave *** A total of 113 consecutive patients were *** mean age was 77.2±5.5 years,and 72 patients(63.7%)were ***1 with the use of Method 1 was larger than EOA2(1.56±0.39 cm2 vs.1.48±0.41 cm2,P=0.001).MG correlated better with the indexed EOA1(EOAI1)(r=-0.701,P0.001)than EOAI2(r=-0.645,P0.001).According to EOAI(EOAI≤0.65 cm2/m2,respectively),the proportion of sever prosthesis-patient mismatch with the use of EOA1 was lower than EOA2(12.4%vs.21.2%,P0.05).Compared with EOA2,EOA1 had lower interobserver and intra-observer variability(intra:0.5%±17%vs.3.8%±22%,P0.001;inter:1.0%±9%vs.3.5%±11%,P0.001).Conclusions For transcatheter self-expanding valve EOA measurement,LVOTd should be measured in the entry of the prosthesis stent(from trailing-to-leading edge),and VTILVOT should match that of the LVOTd measurement with precise localization.